Laura's Law appears headed for adoption in S.F.

Updated 10:34 pm, Monday, June 23, 2014

The San Francisco Board of Supervisors will almost certainly adopt Laura's Law to compel mentally ill people into treatment through the standard legislative process this summer, avoiding the need to put the politically charged subject on the November ballot.

Supervisor Mark Farrell last month announced he had the four votes on the board he needed to qualify Laura's Law for a ballot measure, but he said he was open to passing it legislatively instead if he could get the six votes necessary.

At a committee hearing on the matter Monday, Farrell announced he had struck a deal with Supervisor David Campos, a progressive who has long been adamantly opposed to Laura's Law on the basis that involuntary treatment tramples on the civil rights of the mentally ill.

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The two agreed to a series of amendments that secured Campos' support and ensured Laura's Law will get a full hearing and vote at the Board of Supervisors, tentatively set for July 8. Campos' support gives political cover to other left-leaning supervisors to vote for the law, which isn't popular in the progressive community, and almost assures its passage.

Avoiding the ballot box

Campos is facing off against Supervisor David Chiu, a swing vote on the board between moderates and progressives, in a tight Assembly race in November. Observers believe Campos was fearful that a ballot measure on Laura's Law could be turned into a wedge issue and hurt his chances against Chiu.

"I continue to believe that voluntary treatment is the solution, but I believe that I have the responsibility to ensure that whatever is done is done legislatively at the Board of Supervisors and not at the ballot box," Campos said during the rules committee hearing.

He pointed out that if problems are identified after the passage of Laura's Law at the board, the supervisors themselves could vote to make changes. If it's passed by voters, however, changes to the law would also need voter approval.

Campos and Supervisor Katy Tang voted to send Laura's Law to the full board with the recommendation that it be passed. Supervisor Norman Yee, the third member of the committee, wanted to send it to the full board with no recommendation but was outvoted.

Laura's Law was adopted at the state level in 2002 and is named after Laura Wilcox, a college student who was shot dead by a psychiatric patient at a Nevada County clinic in 2001. The law allows a family member, roommate, mental health provider or police or probation officer to petition the courts to compel a mentally ill person into outpatient treatment, but it does not allow for mandatory medication.

City Hall has grappled with whether to adopt Laura's Law for years, but progressive supervisors and others opposed to the notion of mandatory treatment had always beaten it back. This time around, it seemed obvious Laura's Law would pass one way or another because voters have consistently said in polls that they would approve it.

Opponents speak out

Dozens of opponents spoke out against Laura's Law, however, many of them wearing neon-green T-shirts reading, "Force is the opposite of treatment."

But their opposition appears unlikely to matter this time around. Farrell and Campos agreed to several amendments to secure its passage at the full board, including requiring the Department of Public Health to create a three-person team to oversee the implementation of Laura's Law.

The team would be composed of a forensic psychiatrist, a peer who has dealt with mental illness and a family liaison who has had a family member with mental illness. The team would be responsible for trying to engage a mentally ill person referred under Laura's Law with voluntary treatment first. The team would also help mentally ill people who don't qualify for Laura's Law access services.

The amendments would also provide more training and education for staff members who will implement Laura's Law and make decisions about involuntary treatment.

"These are great additions that strengthen the current law," Farrell said. "And they ensure full passage at the board."

Treatment of the mentally ill

How it works in San Francisco now: Services are available for mentally ill people who want treatment, though advocates say there aren't enough. For those who don't recognize they're ill or who don't want treatment, there are involuntary psychiatric holds at San Francisco General Hospital. Only police officers or clinicians can refer someone for these holds and only if the person is gravely disabled or a danger to himself, herself or others. The most common "5150" hold is for just 72 hours, while longer holds require civil hearings. All allow for compelled medication to be administered.

How it would work under Laura's Law: All of those options would still exist, but Laura's Law would add another layer and would allow family members to petition the courts to compel treatment for a mentally ill relative. To qualify, the person must have been hospitalized or jailed stemming from mental health issues twice in the past three years and have been violent to him- or herself or someone else in the past four years. The treatment would happen in an outpatient facility or in the community and would not allow for compelled medication. The idea is to help people earlier, before they require involuntary psychiatric holds at hospitals. Experts believe it would only apply to about 100 people now living in San Francisco.